An Assessment of the Clinical Uses of Enzymes

CLINICAL USES OF ENZYMES

Clinical Uses of Enzymes

Our bodies are a masterpiece in terms of design – with fine-tuned processes that point to a supreme designer. This discussion reminds me of Psalm 139:14 – we are indeed fearfully and wonderfully made. Enzymes are complex proteins or biocatalysts in the body that catalyze biological systems 1,3. Essentially, enzymes speed up chemical reactions without being changed by the said reaction. Owing to their remarkable catalytic properties, enzymes are used in various metabolic activities. This is more so the case given that reactions that have been catalyzed by enzymes tend to be of high efficiency1. The diagnostic use of enzymes is based on the fact that enzymes can be used to measure any content or changes of specific substances in the body2. Essentially, enzymes are substrate specific and their activity can be measured while other proteins are present. This involves the use of diagnostic enzymes which are essentially used for prognosis of diagnosis. Many metabolic diseases are caused by abnormalities in enzyme metabolism. This is more so the case given that various diseases lead to damage of tissues depending on their onset and severity2. Therefore, enzyme metabolic systems are used as markers of certain diseases in research owing to the metabolic relationship to enzyme metabolism system2. For instance, enzymes are used as markers in inflammatory and autoimmune disorders and bone diseases. One such enzyme that is used to diagnose the said diseases happens to be the alkaline phosphatase (ALP). The said enzyme is a hydrolase and it functions in an alkaline state where it removes phosphates from proteins and nucleotides2.

The rate at which bone grows is related with ALP. In case of a bone disease such as rheumatic arthritis, an increased level of ALP serum serves as an indication that there is active bone formation or increased osteoblastic activity. With regard to autoimmune disease, it would be prudent to note that enzyme matrix metalloproteinase-p (MMP-9) is connected to the pathologic processes that take place in autoimmune diseases2. Research shows that the said enzyme is also a marker for rheumatid arthritis. The said enzyme can be used to monitor patients owing to the fact that it measures serum activity and plays a significant role in development of systemic lupus erythematosus2. In inflammatory diseases such as periodontitis, rheumatic arthritis, and inflammatory myopathies, enzymes cysteine cathepsins (CCs) have been demonstrated in the said diseases. Therefore, CCs are used as diagnostic markers of the said inflammatory diseases.

Enzymes have also been widely used in medicine as therapeutic tools for different metabolic diseases and other pathologies such as cardiovascular diseases and fibriosis conditions3. There has also been some increased interest in research in enzyme therapy owing to the potential therapeutic function of enzymes. Various treatments are based on the ability of enzymes to bring back the altered or lost enzymatic activity. For instance, in the treatment of cardiovascular diseases, enzyme replacement therapy (ERT) is used3. The urokinase enzyme is used in the said therapy. The substrate form of enzyme urokinase is plasminogen which happens to be the inactive form of plasmin. Therefore, plasminogen is converted to plasmin by the said enzyme3. The said conversion happens to be useful in the treatment of cardiovascular diseases owing to the fact that plasmin prevents the proteolytic cascade from participating in thrombosis which is involved in destruction of extra-cellular matrix 3. Clinical research on peptidase is ongoing owing to their increased capacity to degrade deposits of proteins in tissues. For instance, metalloprotease endopeptidases such as MMP-9 and matric metallopeptidase are been studied for the treatment of diseases such as fibriosis conditions. These occur when the extracellular matrix accumulates in the front part of the eye, at the trabecular meshwork. Thus, clinical research has invented a method of using purified collagenase to reduce fibriosis3.